childhood obesity. How to deal with the disease? Obesity in children

The problem of overweight in a child can lead to problems with his health. First of all, a blow is dealt to the cardiovascular system of the body. The risk of developing type II diabetes increases. Diseases that previously only affected the adult population can now be observed in young people. Someone ties overweight in children with heredity. This is partly true, but there are other factors that depend on people. What are the main causes of the global epidemic of obesity in children? How to deal with it?

Causes of obesity in children

There are few reasons why children are overweight. These include malnutrition, overeating, physical inactivity and heredity. Modern life makes parents spend a lot of time and effort on work and travel. This, in turn, gave rise to a culture of fast food, and, as you know, - fast food- Not a very healthy diet. Food fast food contains a lot of fats and sugars. The consumption of such food becomes a habit, and, at times, the child switches exclusively to it. It is also known that the consumption of carbonated sweetened drinks every day in the amount of 600 grams for a year can lead to excess weight of 11 kg. Therefore, to a large extent, obesity in children is due to a lack of control over calories entering the body.

According to a survey conducted by a Scottish university, it was found that the average physical activity of three-year-old children averages 20 minutes per day. Similar figures can be found in other countries. This shows that obesity in children directly depends on the amount of physical activity, and, accordingly, the burning of calories.

How to deal with overweight in children?

It is necessary to direct your efforts to fight overweight, purposefully, especially since the reasons are clear. Even if morbid obesity in children, treatment and prevention may be combined balanced nutrition with moderate physical activity of the whole family. Putting children on a diet should be avoided because it will do more harm than good to the growing body. Diet for children with obesity is unacceptable. It is generally not acceptable for a growing organism. So what can parents do?
- try to ensure that the child's diet includes as few semi-finished products as possible, and more fresh vegetables and fruits;
- Instead of sugary sodas, give your children more water and low-fat milk.
- Minimize the amount of foods high in sugar and fat;
- if possible, do not fry food, but steam it or bake it;
- serve small portions;
- make sure that the children have breakfast before leaving the house so that they do not overeat at lunch;
- do not allow food consumption to take place anywhere other than at the table;
- nutrition of children with obesity, and not only, should not serve as an encouragement or reward;
- Encourage children to play ball, jump rope, rollerblade or bike.
- limit the child's stay with video games, TV or computer;
- organize trips to nature, to the zoo or to the pool;
- give children homework;
- Lead a healthy lifestyle yourself, thereby setting a good example for your child.

These simple tips will help keep your child healthy and well. physical form. Of course, this may not be easy, as in this case, our habits and preferences are affected. However, the effort is still worth it.

Obesity in children is one of the serious metabolic disorders, which is manifested by the deposition of adipose tissue. This disease brings with it many other problems. , which are very difficult to deal with. In addition, the child's health is constantly poor, since living, just moving around and doing some kind of work with excess weight is not at all easy.

Obesity is defined as a condition in which a child weighs more than normal setting more than 15%. You can also talk about obesity if the body mass index (BMI) of the child exceeds 30. As practice shows, children living in the city suffer most from obesity, and the reason for everything is haste and snacks on the go, in McDonald's, pizzerias and stalls selling buns , shawarma, fast food. It is unlikely that such establishments can be found in the village.

But in rural areas there is another danger - cooking with high-calorie animal fats. Therefore, balance and a rational approach are important in everything.

Today, there is a significant increase in children diagnosed with obesity in the world. And this is a serious endocrinological problem. In almost 80% of adults who suffer from obesity, problems of excess weight began in adolescence.

There are many reasons for this state of affairs. But in its nature of development lies polyethology, which means one of the main roles is played by heredity and the environment. So, for example, if both parents suffer from obesity, then the risk of its occurrence in a child is approximately 80%, with obesity only in the mother - 50%, only in the father - 35-40%.

In addition, at risk are children whose birth weight was more than 4 kilograms. However, congenital obesity is diagnosed extremely rarely - only in 1% of cases. Also, those babies who are on artificial feeding and they gain a lot every month, they can suffer from obesity. In newborn babies, obesity often develops due to overfeeding with artificial nutrition. As a rule, it is extremely rare to overfeed a child with mother's milk.

Breastfeeding baby - effective prevention obesity in later life.

If you believe the statistics, then obesity most often develops due to a violation of the diet, frequent snacking and refusal to exercise. Foods that can cause fat deposits include:

bakery products;
fast food;
soda;
sweets;
juices;
Dessert;
sweet teas.

The diet of the child should consist of foods containing proteins and fiber. It is also important to maintain water balance. You should not spend a lot of time in front of the TV or computer and eat food at the same time, since this simply does not control its amount. You need to play outdoor games or at least just take a walk in the yard every evening.

Very often, obesity in children and adolescents appears due to the fault of the parents, as they refuse to work with the diet and follow the diet. And if it does not interest adults, then the child even more so.

Obesity in children is not always a consequence of genetics, sometimes it is one of the acquired serious pathologies. For example, This disease can occur against the background of such diagnoses:

Down syndrome;
meningitis;
Cohen's syndrome;
hypothyroidism;
Pradel-Willi syndrome;
a brain tumor;
Ischenko-Cushing syndrome;
encephalitis.

Obesity can be caused by an iodine deficiency in the body, leading to hypothyroidism. Stress is another important factor. They are associated with the child's admission to school, a change of residence, a quarrel with loved ones.

Classification

Two forms of obesity can be distinguished: secondary and primary, depending on the time of occurrence.
Primary obesity is of the following types:

alimentary, caused by malnutrition;
exogenous-constitutional, caused by hereditary factors.

If genetics is to blame, then it is not the excess weight itself that is inherited, but the peculiarities of the flow of metabolic processes in the body. If we talk about the first type of primary obesity, then it occurs before the age of 3 years, in children 5-7 years old and in adolescents aged 12-17 years. Although its manifestation at a different age is not excluded, but less often.

Secondary obesity occurs due to disease different nature. One of the frequent varieties of this type is endocrine obesity, which can simultaneously occur with diseases of the adrenal glands and ovaries, as well as problems with the thyroid gland.

Degrees of obesity in children (table)

In order to identify this disease in a child, you need to calculate his body mass index (according to the author, it is called the Quetelet index), which is calculated simple actions: the weight of the child must be divided by the value of his height squared. Let's consider a simple example. For example, a boy is seven years old, his height is 1.5 meters, and his weight is 50 kilograms. To calculate BMI, you need to square 1.5, this will be 2.25. Then 50 must be divided by 2.25, the BMI value will be 22.2. After that, you need to refer to the table of average height and weight (given below) for girls and boys and understand if the BMI is within the normal range. As we can see, these indicators are normal, and the child is not obese.

Norms of weight and height of children under 17 years old

As a rule, the most common degrees of obesity can be called the first and second, which are diagnosed in 80% of children. In the absence of nutritional correction, these degrees quickly progress to more severe ones.

Symptoms

Certainly, main symptom Obesity is visible to the naked eye - it is overweight in children. If the disease occurs in children younger age, then the appearance of such symptoms is not excluded:

developmental delay;
constipation;
tendency to allergic reactions;
little activity;
infectious diseases (more often than among peers).

Alimentary obesity occurs with the following symptoms:

fat deposits in different parts of the body.
the appearance of shortness of breath;
increased blood pressure;
loss of interest in physical activity.

Secondary obesity is characterized by more diverse features:

children late begin to hold their heads, walk, sit;
teeth appear much later than in children of their age;
drowsiness;
decreased performance and school performance;
crashes menstrual cycle in girls;
dryness of the skin.

Complications

Obesity itself is dangerous disease. It can develop into complications, thereby worsening the patient's condition. If the diet for overweight children 7 years of age is not followed and treatment is refused, the following diseases may develop:

type 2 diabetes mellitus;
atherosclerosis;
haemorrhoids;
pancreatitis;
hepatosis;
angina;
hypertension;
anorexia;
cholecystitis.

In addition, obesity can lead to other diseases and consequences, such as flat feet, changes in posture, psychological disorders, arthrosis, and scoliosis. Very often, overweight children suffer from depression due to the ridicule of peers and classmates.

If a child has been diagnosed with obesity since birth, then there is a risk of infertility when the reproductive period is reached.

Diagnosis of the disease

Surely we all remember how we were touched by chubby children at birth - this is really touching. For a newborn baby, this is the norm - after all, he only eats and practically does not move. After about 10 months, when the baby learns to walk, all the swelling disappears, as his motor activity increases, and all fats are burned.

However, many parents, seeing how chubby their child was born, are worried - and not whether he is sick with obesity. Only a doctor can diagnose this, but if you do not overfeed the child, then there can be no talk of any obesity. Precisely in order to prevent this disease, every month during the first year of the child, his height, abdomen, and head are measured and measured. In addition, the pediatrician has a special table of averages for a boy and a girl, how many kg they should gain per month.

And therefore, such symptoms that appear externally should not disturb parents:

rounded tummy protruding forward;
plump arms and legs;
tight thighs.

If the child begins to gain more than the prescribed norm, then the pediatrician must adjust the baby's nutrition and his daily routine, if he is more than six months old. Indeed, at the age of 6 months, a child can be interested in toys. It is at this age that babies learn to crawl - which means they are active.

Development of obesity in children

As a rule, obesity begins to develop when the child is gaining a lot of weight, and his parents, grandparents are touched and rejoice at the appetite of their pet. When a doctor talks about obesity, they often do not listen to him and say that he will outgrow it, continuing to feed the baby in the same moderate way. You can’t do this, you need to listen to the recommendations of the pediatrician, especially if the baby is a newborn and is bottle-fed. Failure to comply with the recommendations is fraught with the possibility of developing the first degree of obesity.

If no action is taken, then obesity can develop into a second degree., and the child will regularly eat large amounts of food, since his stomach will be ready to receive food in such quantities. But with the second degree of obesity, other symptoms of the disease, which were mentioned above, may appear. At this degree, only 50% of parents decide to see a nutritionist, because they understand that the child is in danger and sick.

If the parents at this time also decide that the child will “outgrow”, then obesity progresses to the third degree, when all the relatives of the chubby baby begin to sound the alarm. They understand that their child is sick and do not know what to do. At this stage, symptoms of diabetes mellitus, joint pain may appear. It is at this stage of the development of the disease that 90% of parents turn to the doctor, but sometimes it is already very difficult to recover.

Treatment

Treatment for obesity in children should be comprehensive. First of all, you need to follow a diet in order to lose those extra pounds. Often with obesity appear and accompanying illnesses which must be treated without fail. In addition, do not forget to engage in the prevention of excess weight and maintaining the condition that was achieved through treatment.

As mentioned above, diet for obese children should be selected individually Thanks to it, you can lose excess weight. The most important thing is to regularly count the calories of food eaten per day, and eat at least 5 times a day, in small portions. You also need to rationally allocate time. With a child of preschool age, you should walk as often as possible, engage in outdoor games. With schoolchildren 7-8 years old, a lot of time should be devoted to sports and circles for development.

If there are concomitant diseases, then you need to contact narrow specialists. Also in case of obesity, the doctor prescribes the following procedures:

psychotherapy;
acupuncture;
hydrotherapy (especially good swimming).

But sometimes all these measures are not enough to treat obesity, because adolescents may have psychological disorders, and therefore the child will need to be shown to a doctor who can identify the causes of “jamming” of problems. After all, that is why most often overweight is gained in a child of 10 years and older, which occurs against the background of stress.

Not recommended for treatment medical preparations, as they can negatively affect a growing organism. These drugs can be very effective, but should only be taken by teenagers over the age of 15. Surgical operations children are also not shown.

Diet

Of course, the main measure for treatment is diet. However, you should not resort to a diet found on the Internet. It is necessary to select the menu and nutrition for the child individually, together with the doctor, not forgetting about allergic reactions. It is also very difficult for children to explain why they should not use this or that product. Therefore, at the heart of the diet, favorite foods should be present in some form so that the child does not boycott his parents and does not refuse food at all. With obesity of the 2nd degree in children, it is necessary to reduce the number of calories. This can be achieved with the help of vegetable fats and carbohydrates.

If we talk about teenagers at the 3-4th degree of obesity, then the diet for them should be chosen very strictly. It will be necessary to exclude all sweets, berries and fruits, starchy vegetables, pasta.

Last meal no later than 3 hours before bedtime.
The last meal should not be heavy. A glass of low-fat kefir is effective as a dream book.
Between meals, breaks are at least 3-3.5 hours.
Most of the food should be eaten in the morning.

Physical activity

In order to burn excess fat, diet alone will not be enough, you still need to exercise. If a teenager is obese, then he can play sports at home. To do this, you need to purchase a simulator, choose a set of exercises. Another option is to buy a gym membership. With kids, you need to walk in the fresh air, play outdoor games, sign up for a sports club.

Exercise therapy for obesity is a necessary measure to alleviate the condition and treat the patient. It is necessary to choose methods for its implementation according to the age and weight of the patient. You can conduct classes in the following forms:

morning exercises;
jogging before bed
outdoor games;
training sessions.

A set of exercises can be anything, but you should start with simple exercises: walking on toes, heels, full foot. When performing exercises, different organs and muscle groups should be involved.

Prevention

Prevention of obesity is one of the most difficult tasks in the modern world. The first thing parents should start with is to teach the child to the right diet from an early age. You also need to pay a lot of attention to the regime of the day, walk daily with the child in the fresh air.

Any parent should instill a child's interest in physical education and sports, as it is very important for its development. But in this case, parents should be an example for their child.

Prevention of obesity is very important, as in recent years this disease is only gaining momentum in popularity. And no matter how sad it may sound, but the disease appears more and more often in children. different ages. Many people mistakenly believe that obesity causes nothing but difficulty in moving. However, this is a serious disease that is very severe and can affect many human organs.

Coping with obesity is very difficult for adults, let alone children. That is why you should not allow a set extra pounds: with a predisposition to the disease, you need to deal with its prevention, and when the first symptoms appear, treat and eliminate extra pounds.

How to deal with obesity in children and adolescents, the possible consequences of gaining excess weight updated: October 20, 2016 by: admin

This is a chronic metabolic disorder, which entails the accumulation of fat mass under the skin in large quantities. You can talk about it when the weight of the child is 15% higher than the figure that is considered normal at his age, and the body mass index is 30 points higher.

According to studies, about one in 15 children suffer from this problem. According to the same information, children living in cities are more susceptible to it than their rural peers. It is important to note that many adults who are obese develop the disease as early as childhood.

There are 4 degrees of obesity in children:

In the first case, the body weight deviation exceeds the maximum allowable value by 15-24%. It is at this stage that the disease is most often diagnosed.
The second degree is set when the norm is exceeded by 25-50%. In such a situation, the child already has tangible discomfort and the first health problems against this background.
We can talk about the third degree if the weight is more than prescribed at a particular age and with a certain height by 50-100%. At this stage, a serious and complex approach to treatment is required.
The last, fourth degree of the disease makes itself felt when the norm is exceeded by 100% or more. This stage is characterized by severe complications such as diabetes mellitus, hypertension, etc.

To clarify the degree of obesity, doctors, in addition to everything else, also take into account the volume of the hips, waist, chest, fat thickness and current height. Thanks to timely and complete diagnosis, signs of obesity in 80% of all cases are detected at I-II degrees.
Obesity in children is primary, associated with external causes, and secondary, caused by some kind of malfunction in the body and not dependent on the children themselves.

Causes of obesity in children and adolescents

In general, they are very similar - this is unhealthy image life, low physical activity, the use of high-calorie, fatty foods, passion for food from fast foods. The disease can occur due to an increase in the nutritional value of the diet and a sharp increase in the level of consumed simple carbohydrates, which practically do not transform into energy and are deposited under the skin.

Why is the child obese

If we talk about a nursing baby, then the first thing that comes to mind is bad heredity. Scientists have proven that in about 30% of cases obesity is transmitted with genes. But often the parents themselves are to blame for this, who are in a hurry to introduce complementary foods and do it wrong - either they overfeed, or they incorrectly calculate the intervals between meals. Force-feeding is especially dangerous when the baby is not hungry, but parents think differently.

Here are some more good reasons:

Low physical activity. This is true for children who, for example, do not attend kindergarten or are on homeschooling, little walk on the street with their peers. If they play sports, the risk is markedly reduced.
Abuse of sweet. Children are real sweet tooth, most often they enjoy something every day - sweets, cookies, ice cream, halva and other goodies. Naturally, all this is very high-calorie, and when the nutritional value of the diet is exceeded, subcutaneous fat begins to be deposited.
Incorrect power scheme. Not all schools now provide children with a full breakfast, lunch and afternoon snack. As a result, they are forced to subsist on dry sandwiches, cold food, or even go hungry until they return home. Such long breaks lead to a sharp jump in blood sugar and metabolic disorders, which is one of the main factors in the development of obesity.

Causes of obesity in teenagers

At the age of 12-16 years, the greatest danger is the problem puberty. In girls, the work of the ovaries may be disrupted and the level of male hormones may increase, which is quite conducive to the accumulation of fat. should not be excluded and possible problems with the thyroid gland, such as hypothyroidism or hyperinsulinism, which transitional age occurs quite often, especially in boys.

The following reasons should be considered in more detail:

unhealthy food. Those who eat a lot of fatty meat, fish, dairy products, are fond of fried and flour products, and love fast food should be careful.
Metabolic disease. It can be triggered by any diseases of the organs digestive system- pancreatitis, cholecystitis, colitis, gastritis, biliary dyskinesia. In this case, the digestion and absorption of food slows down, which leads to a slow accumulation of fat.
Inactive lifestyle. Modern children prefer computer games to walks in the fresh air. In this case, the calories eaten are slowly consumed, transforming over time into fat.
Stress. This reason is relevant due to the fact that it often leads to an increase in blood sugar levels and an increase in hunger. Often, teenagers try to eat sweet emotions when they have unpleasant emotions. And given that this is the most difficult age in life, which accounts for a lot of experiences, the abuse of tasty is a common practice, and how can fat not be deposited here.

Of the secondary factors predisposing to the development of diseases, chronic sleep deprivation and the use of psychotropic drugs should be distinguished.

Diagnosis of obesity in children and adolescents

Diagnosis is not difficult, difficulties can arise only in determining one or another degree of the disease. It can be suspected with a large, slightly protruding belly, double chin, puffy arms, shoulders and legs. Before the age of about 5 years, this phenomenon is usually considered normal, but if it does not go away, then there is a reason to see a doctor.

Among the most common symptoms are:

Overweight. The child develops a thick fat layer, wrinkles appear on the body and even noticeable stretch marks.
Shortness of breath during physical activity. When obesity occurs, children often have difficulty climbing stairs and playing sports, even when walking slowly.
Increased sweating . It can be explained by hypertension and increased blood sugar that almost always accompany being overweight. As a result, the child sweats a lot both in winter and in summer, this is especially acute during active movements.
Apathy. The patient's working capacity decreases, the desire to play with other children and go in for sports disappears, and there are problems with sleep.
Joint diseases. Due to excess weight, the load on them increases significantly, which can activate the process of cartilage destruction, inflammation of the synovial fluid, pain in the knees, elbows and hips.
Puberty disorder. This symptom is typical for adolescents aged 12 to 15 years. It manifests itself in the absence of menstruation or its disrupted cycle, increased body hairiness, if we are talking about girls, numerous ovarian cysts (polycystic), and an altered hormonal background.
Inguinal hernia. It does not always develop, but an overweight child has all the reasons for this - metabolic disorders, possible constipation, increased load on the intestines.
Frequent bouts of binge eating. In this case, children will lean on sweets and pastries, eat larger portions and eat more often.

Particular attention is paid to the weight of the child, according to his current age and height. It must be weighed and measured to determine the volume of the chest, hips, waist. Until they reach the age of 17, tables with weight norms are relevant, where it is indicated for both boys and girls.

From 1 month to 3 years, you need to focus on the following numbers:

From 3 years to 10 years, the normal weight is:

And this is the norm of body weight at the age of 10-17 years:

In addition to the tables, you need to consult a gastroenterologist, geneticist, endocrinologist, nutritionist and pediatric neurologist. Diagnosis is not possible without biochemical analysis blood. It is necessary to determine the level of sugar, cholesterol, uric acid, triglycerides, protein. Without fail, liver tests are taken and the body's tolerance to glucose is studied. If we are talking about teenagers, then most often the hormonal background is also studied - the amount of prolactin, estradiol, TSH, and cortisol in the blood.

Features of the treatment of obesity in children and adolescents

It should be comprehensive and may include a strict diet restricting simple carbohydrates and fats, physical activity, psychological help, medications and folk remedies. The main goal is to restore metabolic processes, reduce appetite, start the process of splitting adipose tissue. If the cause of the disease is diabetes mellitus, then insulin or pills that lower glucose levels are prescribed.

Children under 12 try not to prescribe pills. First of all, patients are prescribed proper nutrition and calculate calories, which at this age should be approximately 1950 kcal. The eighth diet for obese children is selected.

In the treatment of obesity in children, the following methods are relevant:

Nutrition. It is necessary to abandon simple carbohydrates or limit their consumption as much as possible - sugar and products based on it, potatoes, pasta, vermicelli. All sugary drinks and store-bought juices, fatty meats and dairy products should be excluded from the menu. Eat as many fresh fruits and vegetables as possible, with the exception of grapes and bananas, which are too high in calories. You need to eat fractionally, 5-6 times a day, you should definitely drink more water.
Healing procedures. Regular gymnastics, contrast showers, physiotherapy and reflexology, massage will help. These methods are relevant only for grades 1 and 2 of the disease, when the symptoms are not pronounced.
homeopathic remedies. The most effective drugs are Antimonium Krudum, Hepel, Testis compositum, Graphites Cosmoplex C. The course of treatment is at least 2 weeks, after which a break is taken for several months. Both tablets and drops are taken one hour before meals. Children under one year of age should not be used.

For teenagers in the first place, just as in the case of babies, it is recommended to reconsider your diet. Such children are prescribed diet No. 8, which requires the use of cereals, lean fish and the same meat, bran bread, vegetables and fruits, vegetable oils, green tea.

Active physical exercise, exercise therapy complex, evening walks before going to bed. Great option- enrollment in the sports section, preferably in the pool. Homeopathic remedies are also needed. Given that adolescents often have an unstable emotional state, one cannot do without psychological help. With the permission of the parents, an overeating coding can be carried out.

Drug treatment is also not excluded, which is most often resorted to only with 3 degrees of obesity. The doctor may prescribe Metformin, Orlistat, Sibutramine, Phentermine.

In addition to all this, folk remedies will not be superfluous. A mixture of Alexandrian leaves, dried figs and dried apricots is quite good, each of these ingredients is taken in 50 g. All this is crushed and the finished mass is consumed in 1 tsp. for breakfast and dinner daily. This should be done for a month, after which the course should be interrupted for a week.

Another healthy recipe when there is teenage obesity: mix St. John's wort, birch buds and chamomile (25 g each). Pour herbs hot water(400 ml), let them brew for a day and give the child 200 ml at bedtime along with honey (1 tsp).

Prevention of obesity in children and adolescents

Everything should come down to consuming no more than 1500-2500 kcal, depending on the age, weight and lifestyle of the child.

Nutrition should be fractional, the optimal number of meals per day is 5-6 times, the break between them is 2-3 hours.

It is also important to drink at least 1 liter of water, do not lean on sweets and fatty foods.

The key to success is increased physical activity, running, swimming, cycling and other sports will help reduce the risk of obesity.

It is very important to follow hormonal background, metabolism and mental state of the child. It is necessary to weigh yourself in a timely manner and control your body mass index, focusing on the tables indicated in the article just above.

How to treat obesity in children - look at the video:

Obesity is a very serious disease that requires immediate medical attention and treatment. The sooner it is started, the greater the chances for a successful recovery!

Chubby babies cause real tenderness in many adults. However, being overweight is not only a matter of aesthetic beauty. For supporting good health weight should be maintained within age norm. The problems of childhood obesity will be discussed in our article.

When do people talk about obesity?

A pathological condition in which weight changes upwards and exceeds normal age indicators by more than 15% is called obesity. Many specialists use a parameter such as body mass index to establish a diagnosis. This is the ratio of height in meters to twice the weight in kg. The body mass index is expressed in absolute numbers. Exceeding it above 30 indicates that the child has obesity.

Obesity can develop at any age: both in newborns and in adolescents. According to statistics, obesity is slightly more common in girls under 8 years of age than in boys. However, after puberty, this ratio changes. Often, parents of newborn babies confuse obesity and large body sizes.

If at birth the weight of the child exceeds the norm, then this does not give grounds for making a diagnosis of obesity.

Obese babies live in different countries. There are more of them in economically developed countries than in developing ones. This feature is largely due to overnutrition, low physical activity, as well as the abuse of fast food. In Asia, the number of overweight babies is several times lower than in Europe and America. This is due to the historical food culture and the lack of an abundance of foods containing saturated fats on the Asian menu.

The incidence rates are increasing every year. This trend is rather unfavorable. Two out of ten babies in Russia are obese. In the post-Soviet countries, the incidence is also increasing every year. Approximately 15% of babies living in Belarus and Ukraine suffer from obesity of varying degrees.

In rural areas, there are somewhat fewer children who have problems with being overweight. In many respects, this feature is due to greater physical activity than in the city, as well as high-quality food, which does not contain numerous chemical additives and preservatives. According to statistics, urban kids are obese in 10% of cases. For rural small residents, this figure is lower - about 6-7%.

The onset of the disease in childhood is extremely unfavorable. Many parents believe that being overweight only adorns the child and makes him pretty, however, they are mistaken. It is from an early age that eating habits begin to form in babies. After all, you probably noticed that from the first months of life, the child has his own taste preferences. Some children love porridge and chicken, while others cannot do without eating sweet fruit.

Little sweeties can be identified already from the very early age. If parents at this time encourage each achievement of the child with a candy or a sweet high-calorie cookie, then subsequently the baby develops improper eating behavior. During later life he will be pathologically drawn to sweets and chocolate. Moreover, an adult person will not be able to find any logical explanation for this.

Treatment and diagnosis various problems children's endocrinologists deal with weight. The danger of obesity is that it can lead to permanent disturbances in the work of many vital important organs. Subsequently, babies develop cardiovascular, neurological disorders, chronic diseases. gastrointestinal tract, as well as severe metabolic disorders. Late diagnosis of the disease and non-compliance with the diet contribute to the progression of the disease.

Causes

Obesity in children can be caused by a variety of reasons. Most of the factors arise as a result of external influences. Such an action should be long and regular. This ultimately leads to the development of obesity.

Causes of overweight problems include:

Overnutrition. The daily excess of the calorie content of the daily diet contributes to the oversaturation of the body with various nutrients. He begins to store all the surpluses in reserve. Ultimately, this leads to the fact that the child develops morbid obesity.

Excessive consumption of sweets. Such fast carbohydrates are very dangerous. Once in the body, they begin to be absorbed already in oral cavity. The glucose (ordinary sugar) contained in such sweets quickly leads to hyperglycemia (increased blood sugar levels). In order to normalize blood sugar levels, the body secretes a huge amount of insulin and hyperinsulinemia occurs. This condition is fraught with the fact that all excess sweets are deposited in special fat depots - adipocytes, which contributes to the development of obesity.
Insufficient physical activity. To burn excess calories from food, active movements. Toddlers who eat a lot of high-calorie or sweet foods, but do not attend sports sections and spend most of their time at home with a tablet or phone, are at risk for possible development they are obese. The balance between incoming calories and their utilization and ensures the maintenance of normal weight at any age.

Heredity. Scientists have found that 85% of parents who have problems with being overweight have babies who also have problems with being overweight. For a long time, experts believed that there was an “obesity gene”. However, there is no scientific evidence for this to date. Most likely, in families where family members have developed obesity, improper eating habits have formed. High-calorie nutrition in this case leads to weight problems in both adults and babies.
Chronic diseases. Various pathologies of the pituitary, adrenal glands, thyroid gland lead to pronounced metabolic disorders. Typically, such diseases are accompanied by multiple adverse symptoms. Being overweight is just one of them clinical manifestations. To eliminate obesity in this case, treatment of the underlying disease is indispensable.

Large birth weight. If a newborn baby has a body weight of more than 4 kg, then this is a significant risk factor in his later life for the formation of overweight. In this case, obesity is not big weight at birth, and further overfeeding of the child. Low physical activity only exacerbates the development of the disease.
Strong emotional stress. More and more scientists say that various "jamming" leads to the development of weight disorders. This condition is more common in teenagers. Excessive workload at school, first unrequited love, lack of friends causes a child desire"relieve" stress with a chocolate bar or candy. In children aged 5-7 years, the development of this type of obesity is often caused by a painful divorce of parents or moving to a new place of residence.

In some cases, the combined effect of several factors leads to the disease. Violation eating behavior with reduced physical activity, it always has the most important effect on the fact that the baby has extra pounds.

The intervention of parents in this case should be as delicate as possible. You need to show the child that you are on his side and are trying to help, because you love and care for him very much.

Classification

There are several clinical forms diseases. This influenced the creation of several classifications, which highlight the main options for obesity, taking into account some features. These nosological groups are needed by doctors to establish a diagnosis and choose the right treatment tactics.

All normal weight indicators by age are usually collected in a special centile table. With the help of this document, you can determine the approximate norm of body weight for a child of different sex and age. All children's doctors resort to these tables to determine whether a particular baby has signs of obesity. The norm is the correspondence to the 25th, 50th and 75th centiles. If the child has a weight correspondence of 90.97 centiles and above, then this indicates that the baby has obesity.

Doctors distinguish several clinical forms of the disease:

Primary. It can be exogenous-constitutional and alimentary. In violation of eating behavior and nutritional problems, they speak of food (alimentary) obesity. If the baby has some features of the constitution and hereditary characteristics, then this is an exogenous-constitutional option. Obesity is treated in this case by prescribing medical nutrition and with the obligatory selection of optimal loads.
Secondary. Also called symptomatic. This type of obesity is characteristic of many chronic diseases that cause severe metabolic disorders. In girls, this condition occurs when various diseases ovaries, and in boys mainly with pathology of the thyroid gland. Treatment of excess weight in these situations is impossible without eliminating the causes of the underlying disease. The correct tactics of therapy necessarily include a complex treatment of all chronic diseases that are the main cause of obesity.

Pediatric endocrinologists identify several dangerous periods during the development of the child, when the chance of obesity in the baby is highest. These include age up to 3 years, 5-7 years, as well as puberty(12-16 years old). At this time, parents should carefully monitor the appearance of their child. If the baby has signs of being overweight, then you should definitely consult a pediatrician about this problem.

There is also a classification according to the severity of overweight. It was proposed by A. A. Gaivoronskaya. With the help of this classification, obesity can be divided into several categories, depending on the quantitative excess of weight over normal indicators.

According to this division, there are several degrees of the disease:

Obesity 1 degree. In this case, the weight exceeds 15-24% of the age norm.
Obesity 2 degrees. The excess of body weight over normal values is 25-49%.
Obesity 3 degrees. The excess of body weight over normal values is 50-99%.
Obesity 4 degrees. The excess of body weight over the norm is over 100%.

Appearance

Excess weight significantly changes the appearance of the child. Excess fat accumulates in the subcutaneous fat. Normally, its layer is expressed moderately. With obesity, fat cells (adipocytes) increase in size and volume, which leads to an increase in the thickness of the subcutaneous fat layer. Its greatest accumulation is localized in the abdomen, on the outer surface of the arms and legs, in the buttocks and thighs.

During puberty, there are specific differences in the distribution of subcutaneous fat. So, in girls, the largest accumulation of excess kilograms is deposited mainly on the hips and buttocks, that is, in the lower half of the body. This type of obesity is also called pear-shaped”, as the volumes of the lower half of the body increase predominantly.

The male type of obesity is also called obesity by type " apples". In this case, the accumulation of extra pounds occurs mainly in the abdomen. This type of disease contributes to the fact that the waist disappears, and the configuration of the child's body becomes excessively rounded. Toddlers look uniformly plump, and in some cases even overly full.

Obesity of 2-3 degrees is accompanied by an increase in the thickness of the subcutaneous fat layer in the face and neck. This leads to a change in the appearance of the baby. He has not only cute plump cheeks, but also a short-looking neck. At 4 degrees of obesity, the palpebral fissures narrow somewhat. The appearance of the child becomes sick and no longer causes tenderness, but compassion.

Main symptoms

Obesity causes not only a change in the appearance of the child, but also leads to the appearance of various adverse symptoms in him. So, in sick babies, jumps in blood pressure are observed, the pulse accelerates, resistance to physical exertion decreases, and headache, shortness of breath develops. With prolonged obesity by adolescence, the child may develop metabolic syndrome. This is a dangerous condition caused by persistent hyperinsulinemia. It is dangerous because it can lead to various cardiovascular diseases and diabetes.

With the development of obesity at school age, multiple adverse symptoms appear. So, it becomes more difficult for children to focus on learning new things. educational material, they quickly get tired, they have daytime sleepiness, slowness. For a teenager, public opinion is very important.

Often, obese children experience significant communication problems and make new friends poorly. This leads to the fact that a teenager feels useless and closed to communication, including with parents and people close to him.

If obesity is secondary, then, in addition to being overweight, the child also has other, more dangerous symptoms. So, in adolescent girls with pathologies in the ovaries, the following appear: Clinical signs: hair grows excessively all over the body, occurs acne, severe hair loss appears, the menstrual cycle is disturbed, the skin becomes excessively oily and prone to any pustular inflammation. In adolescent boys with secondary obesity, which has developed against the background of pathologies of the pituitary gland or the reproductive system, disorders such as gynecomastia (mammary gland enlargement), cryptorchidism, underdevelopment of the external genital organs and others appear.

Severe obesity leads to respiratory problems. Excess subcutaneous fat in the abdomen and chest leads to the fact that the diaphragm is significantly compressed. This condition causes the child to develop sleep apnea. This pathological condition occurs during sleep. It is characterized by pauses in breathing, which contributes to the development oxygen starvation vital organs.

Excess pounds put a lot of pressure on the musculoskeletal system. It becomes much harder for the baby to walk and move. In the later stages of the disease, the child cannot even perform normal active movements. While walking, the baby feels pain in the joints and muscle weakness. This leads to the fact that the child walks less on the street and is more at home.

Complications and consequences

The long course of the disease has negative long-term effects. Obese children are much more likely to develop cardiovascular, neurological and orthopedic diseases. Persistent violations in the reproductive sphere lead to the fact that in adulthood they cannot conceive a child and experience significant difficulties with bearing.

Pathological fractures are also most common in people who are obese. In this case, bone fragility is due to significant pressure on the organs of the musculoskeletal system of excess weight. According to statistics, boys who are obese in childhood often develop various anatomical disorders in the feet. This can lead to the development of flat feet and valgus deformities in them.

Disturbed eating behavior leads to the fact that the child has numerous chronic diseases of the gastrointestinal tract. Most often these are: chronic gastritis and pancreatitis, cholelithiasis with the development of calculous cholecystitis, enterocolitis and irritable bowel syndrome.

Often these pathologies in babies move from acute to chronic course. This leads to the fact that the child is prescribed drugs for a constant intake throughout his life.

Diagnostics

Often, parents do not pay attention to the presence of obesity in the baby. Especially if the child is preschool. They think it's cute. Many fathers and mothers believe that all symptoms will go away on their own by adolescence. In some cases this actually happens. However, they do the child a disservice.

Childhood is a very important period of life. It is at this time that the baby forms all the basic habits and behaviors that he will then transfer to adulthood. Eating behavior is also formed in childhood. All taste preferences then remain throughout life.

If the baby gets used to eating fast food or too fatty and fried foods, then later this behavior is fixed in him, as persistent food habit. In adulthood, it will be extremely difficult for him to refuse such products. In order to avoid this, you should carefully monitor the diet from an early age.

When signs of obesity appear, be sure to take the baby for a consultation with the doctor. The specialist will be able to identify the cause of the disease, prescribe a set of examinations to detect secondary obesity, and also recommend to parents what course of therapy is required.

Obesity is a disease that needs to be carefully monitored and treated.

Treatment

According to clinical guidelines, obesity therapy is carried out taking into account the severity of overweight. An integral part of the treatment is the appointment of a diet. If a child has risk factors that provoke the development of obesity, then the diet should be followed throughout life.

Medical nutrition should be low-calorie. Fatty foods, especially those with saturated fats, from children's diet are completely excluded. In the diet of an obese baby, a sufficient amount of coarse fiber must be present. It is mainly present in fresh vegetables and fruits. Industrial sweets (cakes, pastries, sweets, chocolate, etc.) are completely excluded.

In addition to therapeutic low-calorie nutrition, optimally selected physical activity is required. With a slight degree of overweight, a visit to sports sections is suitable. With a significant excess of extra pounds, playing sports without medical supervision is very dangerous. In this case, physiotherapy exercises are well suited.

The intensity and complex of physical exercises are agreed with a sports medicine doctor or a professional instructor with a specialized education. Excessively active training in obese babies is not acceptable, as they can cause various complications in the child's musculoskeletal system. Physical exercises should be performed at a calm pace and with a certain frequency of repetitions.

To eliminate the symptoms of secondary obesity, treatment of the underlying disease is required. In this case, advanced diagnostics may be required. Typically, secondary obesity is treated by pediatric endocrinologists with active participation gynecologists, nephrologists and other specialists as needed. Obesity prevention plays a very important role in preventing overweight in babies.

Rational nutrition, active physical activity and a good psycho-emotional mood contribute to excellent health and maintaining a normal weight throughout life.

Should the weight and height of the child comply with the norms? Dr. Komarovsky answers these and other questions regarding the problems of excess weight in children.

Severe consequences of being overweight
Causes of obesity in children
Prevention of obesity in children

Today, more and more often we meet children whose weight clearly exceeds medical standards. What diseases are caused by being overweight? How does it affect mental health child? What are the causes of obesity in children? How to prevent it?

Severe consequences of being overweight

Parents should be aware that childhood obesity can have severe consequences. It significantly increases the risk of developing diabetes, liver and gallbladder diseases, hypertension, infertility and other chronic diseases. People who have been obese since childhood may develop atherosclerosis, coronary heart disease, myocardial infarction or chronic heart failure at an early age - diseases that are characteristic of older people. An overweight child often suffers from snoring and other sleep disorders. Obesity has a negative effect on psychological condition child: excess weight gives rise to self-doubt in children and adolescents, significantly reduces self-esteem, which leads to problems with learning, and sometimes causes ridicule from peers and, as a result, leads to isolation and depression.

Causes of obesity in children

Most often, overweight in children is the result of malnutrition and a sedentary lifestyle, but it can also be caused by diseases. endocrine system or other serious health problems. The main risk factors for obesity are as follows.

Irrational nutrition
If a child regularly consumes high-calorie, fatty and sugary foods (fast food, snacks, chips, confectionery, pastries, etc.), this can lead to overweight. And if sugary sodas, ice cream, desserts with cream and other sweets are added to this, the risk of obesity increases even more.
Sedentary lifestyle
Lack of physical activity contributes to the accumulation of excess weight, because. in this case, the child burns calories much less than he receives from food. If a child spends a lot of time watching TV, using a computer, or playing video games for a long time, this lifestyle also contributes to the development of obesity.
hereditary factor
If family members are overweight, this is an additional risk factor for obesity in children, especially if the house always has high-calorie foods that are available at any time, and the child leads a sedentary lifestyle.
Psychological factors
Children and adolescents, as well as adults, tend to "seize" such psychological problems, like stress, trouble or strong emotions, and sometimes they just eat out of boredom. Sometimes the cause of overeating is a lack or absence of food. parental attention, and extra calories from food lead to overweight.

Food choices, daily menus, and family meals are up to adults, and even small changes can make a big difference to your child's health.

This is interesting! Treatment for obesity in children depends on their age and general health. Children are not assigned medicines that suppress appetite or promote weight loss. If obesity in a child is caused by a disorder of the hormonal system, weight loss gives a combination of diet, exercise and treatment of the underlying disease.

When shopping for groceries, don't forget fruits and vegetables. Finished industrial products such as crackers, biscuits and muffins, prepared food products, as well as ready-made meals, incl. frozen ones often contain too much fat and sugar, so you should not buy them. Instead, opt for healthier, low-calorie foods.
Never use food as a reward or punishment.

Do not buy sugary industrial drinks, including those with fruit juice, or keep them to a minimum. These drinks are high in calories but contain very little nutrients.
For each meal, try to gather at the table with the whole family. Eat slowly, share the news. Do not allow your child to eat in front of the TV, computer or video game - this leads to the fact that he ceases to control satiety and may eat more than he should.
Try to visit cafes and restaurants with your child as little as possible, especially fast food restaurants. In such food outlets, most of the dishes on the menu are high in calories and contain a large number of bad fats.

To increase the physical activity of the child, adhere to the following rules.

Limit your child's time at the computer and in front of the TV screen to two hours.
Focus on mobility in general, and not on physical exercises - the child does not have to perform any specific set of physical exercises, you can just play hide and seek or catch up, jump rope, sculpt snowman etc.
For the child to be active, show him an example. Think about what kind of outdoor activities the whole family can do.
Never use exercise as a punishment or obligation.
Let your child change activities different days weeks. Let him swim in the pool one day, go bowling on the next, play football on the third, ride a bike on the fourth. It doesn't matter what he does - it is important that he moves more.

Discussion

overweight in children in 90% of cases is a consequence of malnutrition in the family. And while mom says, “my son doesn’t eat anything at all,” he will gain and gain weight, and then at 20 GB, 35 is already a heart attack ... So you can’t wait for grandchildren.

The terrible picture in the body of the article is this one, the bottom one. You could just leave her alone, without the rest of the text and the title of the article. And everything would be clear. Coca-Cola is on the children’s table (or Pepsi, I don’t see the difference - smart car enthusiasts have long adapted both of them for their needs - like washing engines - corrodes cleaner than acids). All the rest of the so-called fast food - what we call fast food - is beyond the power of an adult body to digest without harming itself, and even a child whose everything grows and develops ... And what do children eat in schools? And they don't eat anything. Because tastes are already formed for something else - not for casseroles and cereals, but for chips, nuts, croutons with glutamate and everything that has packaging. That's what they eat, running at recess to a nearby store. We, parents, are horrified when we look at TV screens, which show America and its ordinary inhabitants with an average weight of over 100 kg, regardless of age. And we don’t do anything or we can’t do anything, oppose. There is no national program (Dr. Bormenthal and the Country of the Slender - do not count, although, we must pay tribute to the commercial streak of cunning organizers). In sports, our best of the best from the country is far from ahead of the rest, what can we say about the average Russian then, and sports are far from the priorities of our own national policy. If in Soviet times there were sports sections on every corner, now parents do not know where to attach a preschool child.

The article is correct! As usual, nothing new. More movement and less fat. But what if the child is already full? Or the child thinks that he is full. I recently read a letter from one mom - she has a baby at 6 years old having normal weight would like to lose weight.

Baby goes on a diet

Comment on the article "Overweight in children: causes, prevention and treatment"

Doctors never tire of repeating that obesity is a real war, where there is only one enemy, but at the same time countless victims. This problem modernity is exacerbated by the fact that children are on the “battlefield”.

According to statistics, in the United States, every second child is overweight, and one in five is obese. In Western European countries, these figures are smaller, but they are steadily increasing. The disease is already beyond the scope of hereditary predisposition. Increasingly, physical inactivity and the abuse of fast foods and trans fats are among the main reasons.

Causes

Like adults, obesity in children is difficult to treat. In order for the therapy to be successful, it is first necessary to find out the causes of the disease. To do this, doctors collect an anamnesis and conduct all kinds of laboratory tests.

The most common causes of overweight include:

excess intake of calories;
hypodynamia;
hereditary predisposition;
metabolic disease;
tumor of the hypothalamus, hemoblastosis, skull trauma;
neuroendocrine diseases: hypercortisolism, hypothyroidism;
lack of sleep;
lack of daily routine;
long-term use of glucocorticoids, antidepressants;
gene mutations;
chromosomal and other genetic syndromes: Prader-Willi, Ahlstrom, Cohen, fragile X-chromosome, Down, pseudohypoparathyroidism.

All these risk factors need to be identified in a timely manner in order to begin necessary treatment. Unfortunately, parents often delay until the last degree, until obesity of the first degree turns into the third with all the complications and consequences for life and health.

Symptoms

The clinical picture of the disease is closely related to age characteristics child. So at certain stages of his life, the symptoms may be different. As a rule, the signs of obesity develop progressively, i.e., they appear brighter with each stage.

Preschool age:

overweight;
severe allergic reactions;
dysbacteriosis;
constipation.

Junior school age:

overweight;
excessive sweating;
shortness of breath when walking and physical exertion;
deformation of the figure due to the appearance of fat folds in the abdomen, hips, buttocks, arms and shoulders;
high blood pressure.

Adolescence:

pronounced symptoms described above;
fast fatiguability;
violation of the menstrual cycle in girls;
dizziness, frequent and severe headaches;
swelling of the limbs;
aching pain in the joints;
depressive, depressed state;
conscious isolation from peers.

In adolescence, the disease becomes new level, covering not only the physiology, but also the psychological state of the child. Being overweight does not allow him to fully communicate with his peers. Often this leads to maladaptation, antisocial behavior and even autism.

Diagnostics

Having noticed the first signs of the disease in your child, one should not hope that this is temporary, this happens to everyone, all this is age-related and will soon pass. You need to contact an endocrinologist as soon as possible, who will make the correct diagnosis and give appropriate recommendations.

Collection of anamnesis:

birth weight;
age of onset of obesity;
growth dynamics;
the presence of type II diabetes mellitus and cardiovascular diseases;
neurological complaints: headaches, vision problems;
psychomotor development;
height and weight of parents.

Objective data:

androgen-dependent dermopathy: hirsutism, oily seborrhea, acne;
arterial pressure;
waist circumference;
distribution of fatty tissue in parts of the body;
height;
stage of sexual development.

Laboratory diagnostics:

blood chemistry;
lipidogram;
Ultrasound of the liver to determine its enzymes;
glucose tolerance test to determine insulin resistance;
these are the hormones that will need to be tested for analysis: thyroid, cortisol, ACTH, leptin, parathyroid hormone, proinsulin, prolactin, LH, FSH, SSSH, testosterone, anti-Mullerian hormone, growth hormone;
24-hour blood pressure monitoring.

Instrumental research:

bioimpedancemetry;
MRI of the brain;
ophthalmological examination;
polysomnography;
Ultrasound of the abdominal cavity;
ECG, ECHO-KG.

Molecular genetic research:

determination of the karyotype;
search for gene mutations.

Expert advice:

physical therapy doctor;
gastroenterologist;
geneticist;
gynecologist;
nutritionist;
cardiologist;
neuropathologist;
otolaryngologist;
psychologist;
endocrinologist.

There is no need to be afraid that if a poor child is suspected of being obese, they will be driven through all these studies and analyzes. After collecting an anamnesis, the doctor will make assumptions about what factors caused the disease and prescribe only those diagnostic methods that are necessary to confirm the diagnosis.

Age features

Due to the fact that adipose tissue in the body is formed with different intensity, there are stages of childhood obesity associated with age-related characteristics:

in children under one year old, the first buildup of adipose tissue occurs and obesity is not diagnosed;
1-3 years - a critical period when parents and relatives overfeed the baby with sweets - this is the first stage when symptoms of the disease may appear;
3-5 years - fat growth stabilizes, weight problems are rarely observed;
5-7 years - the second critical stage, characterized by the growth of body fat;
8-9 years - in children of school age in primary school weight problems are rare, as active life, physical education, lessons allow them to spend a sufficient amount of calories;
10-11 years is also a relatively calm stage, but here it is very important for parents to prepare a teenager for the upcoming puberty and instill healthy eating habits in him;
12-13 years - it is at this age in teenage body serious hormonal changes in connection with puberty, which often becomes an impetus for a set of extra pounds.

Knowing the critical periods in a child's life, parents can be more attentive to the problem of overweight at these stages. This will allow everything to be corrected in the initial stages, when the disease has not yet started.

Classification

Doctors have more than one classification of childhood obesity: by etiology, consequences, degrees, etc. In order for parents not to wander into them, it is enough to have minimal information.

First, the disease can be:

primary - due to heredity and congenital pathologies;
secondary - acquired as a result of malnutrition and physical inactivity.

Secondly, there is a special table that will help determine obesity in a child by body mass index (BMI), which is calculated by the formula:

I (BMI) = M (weight in kilograms) / H2 (height in meters).

I degree

A little overweight in a child does not cause anxiety in parents. They even rejoice at his excellent appetite and plump cheeks. The diagnoses of pediatricians are not taken seriously, always appealing to the good health of their child. In fact, obesity of the 1st degree is easy to cure with sports and proper nutrition. But because of this behavior of adults, this happens extremely rarely.

II degree

The disease gradually progresses, which leads to obesity of the 2nd degree. At this stage, shortness of breath and increased sweating appear. Children move little and are often in a bad mood. Problems begin with physical education at school and social adaptation in the classroom.

III degree

At this stage, the disease is already manifesting itself with might and main, so it is difficult not to notice it. The joints of the legs begin to hurt, the pressure rises, the level of sugar in the blood fluctuates. The child becomes unbalanced, irritable, falls into depression.

So parents themselves can determine the degree of obesity at home. This will allow you to seek medical help in a timely manner.

Norm and pathology

In addition to degrees, a table by age will allow you to identify overweight, where, according to WHO data, pathological values body weight. For boys and girls, the parameters will be different. In addition, they still need to be adjusted depending on growth.

Weight of girls 1-17 years old, according to WHO

Weight of boys 1-17 years old, according to WHO

If the child is very tall, it is allowed to slightly increase the parameters given in the table.

Treatment

Parents and the child himself will have to go through the Obesity School without fail. So doctors call a set of measures for the correction of eating behavior and adequate physical activity. This motivational training is considered the foundation of therapy. It is there that clinical recommendations for the treatment of pathology are set out in detail.

Nutrition

First of all, in case of childhood obesity, diet therapy is prescribed, compiled according to Pevzner's table No. 8. Without it, it is impossible to treat this disease.

The Pevzner Special Diet for Children with Obesity recommends including the following foods in their diet in the following amounts:

bread (coarse grinding or bran) - up to 170 grams per day;
dairy products up to 1.5% fat - 200 gr;
soups (minimum potatoes) - 220 gr;
chicken, turkey, lean meat and fish - 180 gr;
millet, buckwheat and barley porridge - 200 gr;
vegetables in unlimited quantities, cooked in any way;
unsweetened fruits - 400 gr;
tea, uzvar, freshly squeezed juices - in any quantity.

Sample menu for obesity 2 degrees

At the first degree, the diet can be varied with honey, more fatty dairy products, sweet fruits, fried foods. At 3 degrees vegetable oil and any concessions in food are excluded.

reduction in portion sizes;
fractional 5 meals a day;
dinner - 3 hours before bedtime;
abundant use of ordinary water;
complete exclusion of fast food, chips, snacks, soda.

Children's diet meals:

curd-banana dessert;
beet-carrot casserole;
dried fruit pastille;
lazy soup with meatballs;
meat soufflé;
cottage cheese pancakes;
chicken cutlets in a double boiler and others.

Recipes

Steam meatballs

150 g of lean beef, cleaned of tendons and film, scroll 2-3 times through a meat grinder. Cook a tablespoon of rice, cool, stir into minced meat. Pass through the meat grinder again, add a quarter of a boiled egg and 5 g of butter. Beat the whole mass with a blender. Roll up small meatballs, put them in a frying pan, thinly oiled, pour cold water, boil for 10 minutes.

Vegetable soup

Chop 2 small carrots and 2 celery stalks. Chop the onion. Mix chopped vegetables, add 100 g of white beans, cut into halves 4 cherry tomatoes. Pour 500 ml of vegetable or chicken broth. Boil after boiling for half an hour. Season to taste sea salt. Before serving, add a little low-fat sour cream.

cupcakes

Grind 1 medium-sized banana and a handful of almonds in a blender. Mix them with grated carrots. Add 200 gr oatmeal, 10 ml honey, 20 ml lemon juice. Fill the molds with the resulting mass, put in the freezer. After 2 hours, move them to the refrigerator for an hour. Serve with tea.

Physical exercise

The treatment of obesity in children is not complete without adequate physical activity. She suggests:

daily sports for at least 1 hour (if more - only welcome);
it is better to devote most of these activities to aerobics;
games;
competitions;
travel;
recreational activities;
various sets of exercises for weight loss.

Medical treatment

Due to age-related contraindications of most drugs, drug treatment of the disease is limited.

In certain cases, according to the testimony of specialists, the following medications may be prescribed to the child:

Orlistat - allowed from the age of 12, helps fats be absorbed in the small intestine;
Metformin - is prescribed from 10 years old with diabetes II type.

The use of drugs such as Octreotide, Leptin, Sibutramine, Growth Hormone is limited to clinical and scientific studies and is not recommended for the treatment of childhood obesity.

According to research, nutrition, exercise and drug therapy have low efficiency. For this reason, in some countries childhood obesity treated with surgical methods. However, clinical trials have shown that the use of bariatrics in children and adolescents (when compared with adults) is accompanied by numerous postoperative complications, low compliance, and frequent relapses in weight gain. In the Russian Federation, such operations for the treatment of obesity in those under 18 are prohibited.

Prevention

Parents should know what is the prevention of childhood obesity:

full awareness of proper nutrition;
breastfeeding up to 6 months;
physical activity;
sports;
constant monitoring of BMI, timely detection of babies with this indicator over 10 at the age of 2-9 years;
instilling healthy eating habits;
walks in the open air.

If all this is implemented from a very early age, children and adolescents will never be diagnosed with obesity.

Complications

The most terrible thing in all this is what this pathology threatens. Unfortunately, parents do not always represent the full danger of the disease. Meanwhile, the consequences can be the most serious - up to death (at 3 degrees).

Among the most common complications:

apnea;
arterial hypertension;
gynecomastia;
hyperandrogenism;
dyslipidemia;
cholelithiasis;
delay or acceleration of sexual development;
pathologies of the musculoskeletal system: osteoarthritis, Blount's disease, spondylolisthesis;
carbohydrate metabolism disorders: insulin resistance, impaired glucose tolerance, fasting glycemia;
fatty liver: hepatosis and steatohepatitis are the most common conditions in children;
relative androgen deficiency;
diabetes mellitus type II;
diseases of the gastrointestinal tract: inflammation of the pancreas, gastritis, hemorrhoids, constipation;
liver failure;
mental illness, psychosocial disorders;
decrease in male reproductive function, female infertility in the future.

Parents should understand that obese children are unhappy. Therefore, their main task is to prevent such a development of events, and if this has already happened, to do everything to cure the child. The sooner adults realize it, the more chances for recovery and a prosperous life he will have in the future.

How does it manifest

Obesity is diagnosed at any age, but most often develops in children during critical periods:

From birth to three years;
School time 5-7 years;
Adolescence.

As practice shows, many parents do not know the structural features of the child's body. If in infancy a child is regularly shown to a pediatrician, which guarantees timely detection of the disease, then at school and adolescence this happens much less frequently.

Symptoms of the disease in children older than three years:

Sharp weight gain, not proportional to growth;
Shortness of breath with little physical exertion;
Pain in the back and joints;
Violation of the menstrual cycle in girls or its early onset;
Constipation, allergies, frequent colds;
Increased blood pressure;
Fatigue, low physical activity;
An increase in the fat layer on the abdomen, chest, back, limbs.

The thickness of the fat layer in the abdomen, chest and on inside hips can be determined by pinching it between the fingers. The norm of the layer in the abdomen and chest is 1-2 cm, in the hips - 3-4 cm. Excess of these indicators indicates overweight.

If you have concerns about the weight of the child, be sure to consult a specialist. The medical staff will conduct a complete examination of the child using body mass index (BMI) charts and specialized computer programs.

Classification by type and degree

Childhood obesity is divided into 2 types based on its causes:

primary obesity. It occurs due to malnutrition or is inherited. Moreover, not obesity itself is inherited, but concomitant disorders of the body's metabolic processes. If the mother is diagnosed with obesity, then in 50% of cases these disorders will pass to the baby. If the father has 38%, both have 80%.
secondary obesity. It is caused by acquired diseases, for example, of the endocrine system.

There are 4 degrees of obesity in children:

I degree (weight above the norm by 15-24%);
II degree (weight above the norm by 25-49%);
III degree (weight above the norm by 50-99%);
IV degree (weight above the norm by more than 100%).

In 80% of cases of primary obesity, I and II degrees are diagnosed. The presence of a slight excess weight in a child, as a rule, does not cause any anxiety in parents. Most often, they rejoice at the good appetite of the child, and they treat the diagnoses of pediatricians with a grin, arguing their position as “well, he feels good.”

If the diet is not followed at the first stage of obesity, then the disease continues to progress and goes into stage II. There is shortness of breath, increased sweating, the child begins to move less and more often demonstrate Bad mood. However, even here parents are in no hurry to treat their child. The disease continues to develop. If in the first two stages the situation can be corrected by a diet, then in the subsequent stages everything is much more difficult.

If the weight of the child is higher than normal by more than 50%, then obesity of the III degree is diagnosed. At this time, the teenager begins to hurt the joints of the legs, the pressure rises, and the level of sugar in the blood fluctuates. The child himself becomes irritable, complexes appear, which leads to depression. Exacerbate the situation of ridicule from peers. It is at this stage that parents begin to do something. However, the standard diet is not able to solve a problem of this magnitude.

Complications and consequences

Health problems can begin, including with a little overweight. Therefore, you should not hope that everything will go away by itself, it is necessary to treat the child at the first signs of the disease.

Obesity increases the risk of diseases:

Decreased immunity;
Cardiovascular system: hypertension (increased pressure), angina pectoris (pain in the center of the chest), atherosclerosis (arterial disease);
Musculoskeletal system: chronic diseases of the joints, violation of posture, deformity of the foot;
Diabetes;
Disorders of the digestive system: pancreatitis, fatty hepatosis (which can lead to cirrhosis of the liver);
Chronic cholecystitis, cholelithiasis;
Dysfunction of the gonads in adolescents: underdevelopment of the genital organs in boys, disruptions in menstruation in girls;
Hemorrhoids, constipation, fistulas.

Being overweight makes a child unhappy nervous system, which will result in:

Malnutrition: from bulimia to anorexia;
Sleep disturbance, snoring, etc.;
Frequent headaches, depression.

Due to the risk of complications, the treatment of obesity in children should not be delayed.

In children under three years of age

Obesity in children of the first year of life is diagnosed quite often, but it is more of a recommendation than a serious diagnosis. The development of the disease in children under one year is associated with:

heredity;
Maternal smoking during pregnancy;
Feeding with a high-calorie mixture;
Incorrect introduction of the first complementary foods;
Overfeeding;
Wrong diet;
Late onset of crawling and walking;
Little mobility.

Breastfeeding in the first year of life is a good prevention of obesity in infants.

The most common solution to a problem identified in a child under three years of age is diet. At timely treatment the disease disappears in 2-3 years.

When diagnosing obesity in babies, a centile table is used, which shows the relationship between their age, weight and height. Information is being collected about the child's diet and diet, the corresponding diseases of his close relatives. The value of BMI for children from one to three years is not indicative.

In school-age children and adolescents

With the beginning of school life, children begin to move less, and use their pocket money to buy buns, chocolates and other high-calorie foods. Add to this the stress that schoolchildren experience in an unfamiliar environment for them, and the reasons for weight gain become obvious.
Obesity in children and adolescents is most often caused by:

sleep deprivation;
Predominantly sedentary lifestyle;
Lack of diet;
Hormonal changes in the body (puberty);
Stress.

It is worth noting that teenage obesity most often passes into adulthood.

Diagnosis of obesity in schoolchildren and adolescents, as in children under three years old, begins with an anamnesis. Height, weight, chest, waist and hips are measured, BMI is calculated. With the help of special centile tables, the relationship of these parameters can be traced and a correct diagnosis can be made.

To determine the cause of obesity in children, prescribe:

A blood test for biochemistry, which determines the level of sugar, cholesterol and other substances that increase the risk of complications in obesity. At elevated level additional glucose tests are ordered.
Blood and urine tests for hormones to determine endocrine disease.
Computed or magnetic resonance imaging when pituitary disorders are suspected.

In addition to a pediatrician and a nutritionist, you may have to go through an endocrinologist, neurologist, gastroenterologist and other doctors. It all depends on what additional diseases will have to be treated.

Features of treatment

If you notice that your child is overweight, you should definitely contact a nutritionist. Most likely he will need only a special diet. Obesity in the early stages is much easier to treat. If obesity has already passed into the III or IV degree, then you need to act as soon as possible.

First of all, the treatment of obesity in children requires nutritional correction.

The diet includes:

Reducing the size of 1 serving;
Compliance with the regime of fractional five meals a day (preferably with the whole family). In this case, dinner should not be later than three hours before bedtime;
Replacing sweet store-bought drinks with water;
Inclusion in the daily diet of fresh fruits, berries and vegetables (for diabetes, sweet fruits should be excluded);
Exclusion from the diet of fatty meat, fish;
Sufficient water intake;
Limiting the consumption of "fast" carbohydrates: flour products, pasta, semolina;
Limiting the consumption of sweets (from sweets, give the child honey, dried fruits, marmalade, marshmallows and dark chocolate), and in case of diabetes, sugar-containing foods should be excluded to the maximum;
Limit salt intake, exclude pickled and pickled vegetables from the diet;
Exclude fast food, chips, snacks and more.

During this period, any diet that involves starvation, as well as mono-diets, is contraindicated for the child. Since they will only aggravate the course of the disease. In the daily routine, it is necessary to include walking, lasting at least 30 minutes, and playing sports 3-5 times a week. In the morning it is advisable to do exercises.

Drug treatment, as well as a specialized diet for diabetes, are prescribed only by a doctor.

Prevention of obesity in children

In order for the child not to face the difficulties of being overweight, it is necessary to prevent obesity in children. It should be carried out by parents, educators and teachers.
The health of children is more dependent on us adults. Parents from infancy should instill in their children the right eating habits, talk about the importance of proper nutrition and demonstrate this by their own example.

A diet built on the foundations of a healthy diet should firmly enter the life of every family member.

An important role is the regime of the day, which provides for a diet, the necessary sleep and physical activity. From the first year of life, you need to instill in your child a love for sports. This process takes place naturally and harmoniously in those families where the parents themselves lead an active lifestyle.

Age	Normal range in girls		Normal range in boys
Age	Weight, kg	Height, cm	Weight, kg	Height, cm
1 year	9, 3 – 11, 8	74 - 80	10, 1 – 12, 7	76 – 83
1 year 6 months	10, 4 – 12, 6	78 – 84	10, 5 – 12, 9	78 – 85
1 year 9 months	10, 8 – 13, 5	80 – 87	11, 8 – 14, 3	83 – 88
2 years	10, 9 – 14, 15	82 – 90	11, 8 – 14, 3	85 – 92
2 years 6 months	12, 3 – 15, 6	87 – 95	12, 6 – 15, 3	88 – 96
3 years	13, 3 - 16, 1	91 – 99	13, 2- 16, 7	92 – 99
4 years	13, 8 – 18, 0	95 – 106	14, 9 – 19, 3	98 – 108
5 years	16, 0 – 20, 7	104 – 114	16, 6 – 22, 7	105 – 116
6 years	18, 2 – 24, 5	111 – 120	18, 7 – 25, 1	111 – 121
7 years	20, 5 – 28, 5	113 – 117	20, 6 – 29, 4	118 – 129
8 years	22, 5 – 32, 3	124 - 134	23, 2 – 32, 6	124 – 135
9 years	25, 1 – 36, 9	128- 140	24, 7 – 36, 5	129 – 141
10 years	27, 9 – 40, 5	134 – 147	28, 5 – 39, 0	135 – 147
11 years	30, 4 – 44, 5	138 – 152	29, - 42, 1	138 – 149
12 years	36, 5 – 51, 5	146 – 160	33, 8 – 48, 6	143 – 158
13 years	40, 4 - 56, 6	151 – 163	40, 6 – 57, 1	149 – 165
14 years	44, 6 – 58, 5	154 – 167	43, 8 – 58, 5	155 – 170
15 years	47, 0 - 62, 3	156 – 167	47, 9 – 64, 8	159 – 175
16 years	48, 8 – 62, 6	157 – 167	54, 5 – 69, 9	168 – 179
17 years	49, 2 – 63, 5	158 – 168	58, 0 – 75, 5	170 – 180

Age	Symptoms
Preschool	body weight exceeds the norm; gastrointestinal problems (frequent constipation, dysbacteriosis); severe allergic reactions.
Junior school	overweight; increased sweating; the figure is modified (fat folds appear on the abdomen, hips, arms, buttocks); jumps in blood pressure.
teenage	all of the above symptoms are aggravated; in girls, the menstrual cycle is disturbed; dizziness; persistent headaches; fast fatiguability; swelling of the legs and arms; pain in the joints of a aching character; depression, depression; deliberate refusal to communicate with peers.